p.m., a discussion on the future of congressional redistricting from the federalist society. on c-span2, witness testimony continues in the trial of former minneapolis police officer derek chauvin, who is charged in the death of george floyd. veterans affairs secretary dennis mcdonough testified on his agency's covid-19 response as well as what they have focused on during the first months of the biden administration. this house veterans affairs committee hearing is two hours and 35 minutes. is two hours and 35 minutes. >> glad to welcome secretary mcdonough to his first hearing with the house committee on veterans affairs. when president biden announced your nomination i knew the v8 would be in good hands with a true problem solver at the helm and i am eager to get to work with you.

last congress, we secured several important wins for veterans. the commander handed act -- hannon act and veteran's comeback i. earlier this month we came together to pass the american rescue plan to ensure v.a. as the funds it needs to continue serving our veterans throughout the covid-19 pandemic. this includes additional resources for homeless veterans. i understand there was some confusion on this point. i appreciated cnn's efforts to work with applicants to set the record straight. i am so proud of these accomplishments but there is still much more to do. i also want to think -- thank you to pass hr 26 signed by the president yesterday. this new law explains -- expands the authority -- v.a. authority.

the strength of v.a.'s internal health care system and the department successful role in national vaccination efforts is what makes consideration of new authorities like this possible. to be clear, any expense you must be contingent upon the v.a. and supply of the vaccine and v.a. must continue to prioritize vaccinations and health care delivery for our nation's veterans enrolled in v.a. care above all else. as v.a. continues to confront the covid-19 pandemic, our committee will work to create a more welcoming v.a. and build equity for veterans, reduce veteran suicide, address toxic exposure, and ensure veterans receive quality education, advocate for women veterans, modernize the v.a., support v.a.'s long-term care

facilities, improve management and oversight, and ensure our legislative reforms are implemented effectively. after the immediate crisis of the covid-19 pandemic subsides, there is one challenge that must be addressed above all else in v.a.'s first 100 days, the veterans at loss of confidence in the v.a.. over the last four years we saw turmoil at the agency. whistleblowers were targeted for retaliation. survivors of sexual assault, sexual harassment, and assault questioned and diminished and there was hostility toward organized labor. efforts were taken to obstruct congress's constitutional oversight responsibilities. in the wake of this field leadership is an issue that needs to be resolved for veterans, the workforce, and the american people. cultural change starts at the top, and it is my hope with

secretary mcdonough's abatement and demonstrated track record of solving problems the v.a. can build back veterans trust and make sure all staff feel safe and welcome walking through its doors. that is why at one of my top priorities this year is to create a more welcoming v.a. for all veterans regardless of gender, sexuality, gender identity, race, housing status, or citizenship. no veteran should face barriers accessing the care or benefits they have earned, and no v.a. employee should face discrimination in the workplace. given emerging information about troubling connections between the veteran community and extremist groups, we need to rebuild bridges to veterans who may feel they are outside the community. by restoring veterans'faith in the v.a. and confidence in the system we can create and

strengthen veteran connections to community while also building a stronger and more welcoming and more effective v.a.. as long as 17 veterans died by suicide each day our committee will continue our efforts to reduce veteran suicide. this congress will keep finding for extended needs counseling to all veterans. staff, contractors, network providers, and caregivers can provide life-saving information to our veterans. we work to make sure community providers have a better understanding of the military and veteran culture it so they can provide the best treatment possible and will support efforts for increased outreach for our most at risk veterans, including women, lgbtq plus veterans. it is long time we recognize toxic exposure as a cause of war. we finally passed the act last congress but it took more than four years. we cannot let that happen again. the burden of proof should not be on our veterans and there

should be no reason why they and their survivors should have to fight v.a. for the care they have earned. if america is willing to send our service members into harms way, our nation must be willing to ensure that we take care of all of those. i am committed to encumbrance of legislation to address toxic exposure this congress. i know many of you -- many of these overlap with priorities of the v.a. and i look for during his testimony. these first 100 days present an opportunity to build back trust in the v.a.. it is my hope that together by working with secretary mcdonough , president biden, our senate colleagues and the dso committee we can continue -- vso community we can continue to support these efforts. i go back my time. i not recognize you for five minutes for your opening remarks.

sec. mcdonough: thank you, chairman, and welcome, mr. secretary. we were able to meet in person a couple weeks ago. thank you for testifying before the committee virtually this afternoon. i hope your appearance today is the first of many. if are taking the help of the department of veterans affairs as an interesting time. with the white house chief of staff in 2014 andnationwide accs [indiscernible] at the v8 the hard work of this committee and the trump administration lead to landmark legislation. the legislation has begun to transform virtually every aspect of the v.a. more importantly it is improve the lives of veterans and their families. veterans have greater access to care, education. the v.a. has gone from one of the worst to one of the best

places to work in the federal government. the title of today's hearing, restoring faith by building trust, but the fact is trust reached its highest level last year according to a survey with veterans who had recently interacted with the department. those are tremendous successes. they should not be forgotten or set aside. that is not to say that we are not in a position where we have to face challenges and do some changes. we grieve the more than 10,000 veterans and approximately 135,000 v.a. employees who have lost their lives during covid-19 and we stayed with the millions of other veterans who lost their loved ones, their jobs, their health, their homes, and their support systems to it. i stand ready to work with you, mr. secretary, to make sure you

have all the tools you need. covid-19, the most unprecedented challenge for v.a.. congress provided v.a. with an unprecedented amount of resources to pay for. that was in addition to a historical baseline. $10 billion that congress gave the v.a. still has not been sent -- spent. an additional 17 billion dollars 17 weeks ago. every single one of those dollars come from the pockets of hard-working americans. every single one of those dollars should be spent as they were intended, for covid relief, or returned to the american people. i am going to hold you accountable for that, mr. secretary. [indiscernible] we do not always see eye to eye on that or other important issues, but let me say this, i have no doubt that we

fully agree on one important thing. i respect and commitment to veterans and their families. we have many priorities in common. we both want them to get the care and benefit they deserve. we both want to support the culture. we both want to strengthen service for women veterans. we both want to stop veteran suicide. we both recognize that veterans are a force of good. they come from every age, race, background, creed, and community. they reflect the bravery and beauty of our country, and when they succeed we all succeed. i look forward to working with you to honor their service and to support the in their civilian lives. thank you for being here and with that, i yield back. >> thank you ranking member bost

. i know it will introduce our witness today. it is a pleasure to welcome the secretary of the department of veterans affairs, dennis mcdonough to testify before our committee for the very first time. today is his 45th day on the job and he could not have stepped into this role at a more critical time. he has worked tirelessly in public service during his career , and his reputation as someone who is pragmatic and ready to engage and collaborate on tough issues is exactly what we need at the v.a. i look forward to hearing you lay out your vision and how you will move v.a. for its mission to serve veterans. if you are not recognize for 10 minutes to deliver your testimony. sec. mcdonough: distinguished members of this committee, thank you for this opportunity to discuss my parties for v.a. and

thank you for the very warm welcome -- my priorities for the v.a. and thank you for the warm welcome. we are able to appear here insecurity because of the sacrifice of veterans. it is an honor to serve as secretary of v.a.. let me acknowledge our colleagues not here. in their insights and support make v.a. better. let me think the committee for increasing its work on vaccinations. as the chairman said yesterday president biden signed the same supply sector that we will use that authority to vaccinate all veterans, veteran spouses, and caregivers. also for passing the american rescue plan. significant resources that will help us to continue to provide veterans the best care and services doing -- during the pandemic. my first 45 days at the v.a. have been inspirational. we celebrated african-american events during black history month, and this month the

enormous contributions of women veterans. two groups of veterans who fought for equal rights and freedom even when they did not fully share in them. the many leaders and employees i have met at v.a. are highly skilled, dedicated, exceptional professionals. many veterans themselves. it president biden at the same impression during his visit to the d.c. v8 medical center earlier this month. the pandemic has challenged v.a., our employees, their families, and all-americans. our employees have showed unwavering strength during historic demands caring for both veterans and their own families. i am proud of them. they live the v.a. values, integrity, commitment, respect, and excellence. the pandemic impact of veterans has been significant. protecting debit responding to their needs during this pandemic is currently our main effort. we have administered over 3.3

million doses of vaccine to veterans, veteran caregivers, v.a. employees and colleagues from other federal agencies. we are determined to vaccinate as many veterans as possible and to expand the pool of veterans we are able to vaccinate. because of covid many veterans have delayed health care, including mental health care. when they return, your conditions may be more complicated because of those delays, and we know from previous economic downturns that veterans who lose their jobs and help care benefits often turn to v.a. for assistance. as the pandemic ebbs we expect and are planning for a surge in requests for care and services. aarp investments will be important for that effort. to reduce the impact and keep veterans connected to their health care teams during the pandemic, we have provided tens

of thousands of internet and cellular connected devices to veterans, especially those in remote locations. many veterans have chosen telehealth services that have increased by over 1700% between february of 2020 in january of this year. the pandemic has also had an impact on the processing of pension claims. the claims backlog as increased from 76,000 cases in march 2020 two over 200,000 -- to over 200,000 today. covid impacts are broad, but with the american rescue plan, and help is here, and help is here, help that will significantly ease many pandemic related challenges. those resources will allow us to reimburse copayments veterans have made since april 2020 and alleviate that burden through september of this year. copayments should not be an

obstacle to care during the pandemic, and these resources will help us build new facilities and improve operations of living conditions at state veterans homes. decrease the compensation and pension claims backlog by over 112,000 by the end of 2022 and train veterans unemployed due to the pandemic in high demand occupations and high tax education programs. in short, the vital support the american rescue plan provides will help alleviate some of the pandemic's most devastating effects, and it goes a long way in caring for veterans and their families, what president biden sees as our country's most sacred obligation. when it comes to billing that obligation the president charged me to be a fierce advocate for veterans. to that end, we are focused on four fundamental doubles as a vision for the future. advocacy, access, outcomes, and excellence. at first, v.a. is going to be

the nation's premier advocate for veterans, their families, caregivers, and survivors. veterans have made a down payment sometime in blood and the visible wounds that may affect them the rest of their life. this sacrifice has earned them the care and services we provide. we exist to best serve them. not to do what is easy for v.a.. second, we will provide timely access to v.a. resources, world-class health care, urged benefits, and a final resting place that is a lasting tribute to their selfless service. veterans deserve access to educational opportunities, training, and jobs worthy of their skills and service so that they can continue to strengthen our communities and our country with their leadership. they contribute to every field and endeavor. at they have been doing so since we became a country. we must work together to make sure they have the access and opportunities to continue that tradition.

we will seek new ways to ensure our most notable veterans have easy access to care and services that reduce veteran homelessness and importantly suicide. our most vulnerable veterans want to receive care at their homes from those who love them and are best suited to care for them. we will help provide access to that care as well as opportunities for the training, support, and resources our compassionate caregivers need. third, federate outcomes will drive everything that we do. v.a. as a proud history of leadership with data and health informatics. we have some of the nation's top talent. we are watching our strategy to manage and integrate our data holdings responsibly and ethically to empower veterans and their service. good data, science, and

evidence-based policymaking are fundamental to effective and efficient expansion of our covid vaccination campaign, providing quality health care, tracking and managing benefits, and measuring veterans'experience and their satisfaction in their experience with us. we will rely more heavily on data in the future than we ever have before. fourth, we are going to seek excellence in all we do by leveraging the strength and diversity that defines our veteran population, our v.a. workforce, and our country. we will work to ensure every veteran is afforded access to capacity and resources, diversity, equity, inclusiveness are fundamental to everything we do. we welcome all veterans, including women, veterans of color, and lgbtq veterans. every person entering a v.a. facility must feel safe, free of harassment and determination.

we will never accept determination, harassment, or assault. diversity is a strength, never a weakness, among veterans, v.a. employees, and all of america. advocacy, access, outcomes, excellence. i recently received a letter from a veteran's son. his dad recently passed at our hospital in madison, wisconsin. he wrote, while saying goodbye to my dad has been difficult, one thing that gives me comfort is the extraordinary career he received while at the v.a. the staff always displayed patients -- patience and grace allowed my dad to maintain dignity. the smallest test was also -- always do with gentle demeanor and every interaction i observed was uniquely human. a shot was accompanied by a moment of holding his hand.

moving his position it was done gently and with calming, reassuring voices. every single step member i interacted with with always professional, unfailingly caring and a genuinely good person. that is the kind of dignified excellent care every veteran and every family member deserves to experience every time. mr. chairman, ranking member bost, i look forward to working with you in this committee. if you have a critical role to play, and i respected. congressional oversight and information sharing allow us all to make better decisions, the best decisions and serving our vets. i haven't made the same commitment to transparency and openness to our independent inspector general and to other government oversight agencies in our department. at last, i would like to simply remember the veterans and v.a. employees who have lost their lives to covid. we mourn each loss and offer our

deepest condolences to their families. thank you for the opportunity to appear before you today and for your continued support of veterans. i look very much work to your questions. >> thank you very much for your testimony. i will recognize myself in the first five minutes for questioning. mr. secretary, we know from independent research that veterans get mental health care in the v.a. superior to the care they can get in the committee on average. v8 mental health care providers -- v.a. mental health care providers understand veterans' unique needs required to keep up-to-date for a range of mental issues veterans may face, including suicidal thoughts, ptsd, and military sexual assault. we went veterans to continue to get care in the community when

appropriate but veterans deserve community providers trained at the level of v.a. providers. i want to ask you if you will commit to making in-house training and evidence-based treatments mandatory for health care providers? sec. mcdonough: thank you for the question. at bottom line here is, it is fundamental that we not only share the best practices that we have but we also first and foremost to maintain that capacity in the v.a., so we have an aggressive effort to maintain our capacity in-house, to increase by using some of the tools and authorities you have given us to increase and grow that capacity. third, you have given us through some of the acts you talked about in your opening statement, including the act from last year, additional tools and authorities to allow us to

engage local community providers to learn from our best practices and make sure we are in contact with veterans through their local communities, so we intend to use those authorities and resources as well. on the question of whether i will commit to mandate that training, let me take that one and study it. there is no doubt we need to use the authorities you have given us to share those best practices and through the hannon act as we implement grantmaking provisions share those capacities. as to mandating it let me take that and i will work with you and your staff and the committee to make sure we are using that in the most effective way. >> thank you for the response. in recent years, there has been considerable attention placed on securing presumptions for those veterans subject to toxic exposure, including burn bans.

aside from offering disability compensation perceptions grant access to v.a. health care. we note just over 4 million veterans have served since 9/11 alone. giving congress the attention on this topic, as we had done any assessment to determine the impact of potentially enrolling hundreds of thousands of veterans into the health care system in a relatively short period of time? sec. mcdonough: we are obviously constantly reviewing questions around exposure but also preparing ourselves for extended care. this is why the expended resources we anticipate needing with the increase care post pandemic is so necessary. as it relates to exposure generally, what we have been putting in place is a posture

where we are not passively waiting for information to come from us -- -- from new partners who might have useful signs to up us understand the impact of exposure. making sure that constantly considering that new data. i have put in place a process by which each quarter we will be spending time in a meeting i chair making sure we are looking at the most recent science on exposure and what that means for our veterans. and the last thing about presumption -- what we also know is the lack of a presumption serves as a disincentive to vets applying for benefits or care at the first instance. that suggests a lack of trust in

the process that they can get a fair hearing on their claim, so we have a much more active posture and understanding what art vets are going through, surveilling the experience of all the vets and including continuing active duty members, what they are experiencing and using all of that data to inform credible consideration of claims so that vets have trust and confidence in the system even as we build the science to make the case on presumption. >> mr. secretary, my time is up but i went to get to issue of making sure the v.a. does it review. we are in the process of considering legislation which may have a substantial impact on the dha.

what resources will the v.a. need to successfully absorb an increase of veterans it would system? i don't call on ranking member bost for his -- i now call on ranking member bost for his five minutes. >> [indiscernible] how soon do we think the v.a. will start offering vaccines to all veterans, caregivers, and staff? sec. mcdonough: we have to do a couple of things immediately to make sure we are ready. let me give you one example. right now, we have a statutory requirement to report to the cdc anybody who gets vaccination from us. that is really straightforward when we have a vet who is enrolled with us, because she is edible with us, she gets the vaccination, and it automatically goes to cdc. we have to build that capacity

for not enrolled vets and for caregivers, so that will take a little bit of time. the longest [indiscernible] is supplied. we are assuming supply as we get it. we are very focused on may 1 being the period went everybody -- when everybody can access the system, but to be honest with you right out of the gate there will be flexibility in our system. we are learning through briefings throughout the day that some vets are able to get appointments as soon as today, but we are going to have to be very precise and disciplined and argue medication with vets and communities and we will have to be exceedingly aggressive in our execution. >> how many more individuals?

have you been able to check on that number to think how many more individuals we are going to be able to offer the vaccine to and what those numbers look like? sec. mcdonough: we have been targeting our efforts today at the roughly 1.46 million vets that rely on us for care. as you step up the additional categories that you have now enacted you get up to around 24 million, so it is kind of a fourx growth and that is why we are being disciplined and executing and communicating to our vets so that they know what to expect from us and can plan accordingly. the bottom line is what i urged individual vets to do is to be in touch with their local v.a. consider, and all the same -- med center and all the same platforms we are using right now will be the same we used to schedule the others.

>> how are you getting the word out to those individuals that are now available to receive this? sec. mcdonough: we are going to use every channel we have. u.s. mail, standard email, social media platforms, our vso's, we are hoping to work with you all as you talk to your constituents and make sure we are using some of these new tools. this new tool our technologist have come up with as work exceedingly well. it very well with vets of every generation. there is some sense older vets are not tech savvy in this way. that is not what we are experiencing. it has been a very effective tool. >> that is good. do you think you will be able to keep up with the amount of vaccines to do this? sec. mcdonough: right now we

are. we are moving what we get into arms within 3 to 5 days but you meet the numbers we are talking about we will have to see twice the capacity we are moving and we are making sure we are ready for that. >> please let us know how in congress how we can help. one other thing i need to ask, i want to thank you. it is a right call you are reviewing the ehrm and changing the report going forward. what can you tell us about where we are at? [indiscernible] what are you looking to find out in that timeframe? sec. mcdonough: thanks so much. i should have said this before, i really enjoyed our opportunity

to talk and i look forward to engaging all the members of the committee. i have a rule, which is no surprise to you all, and as you said we may not always agree but you will never wonder why or what. as it relates to ehrm, i will tell you what struck me. you all know this. we are seeing productivity declines bigger than i would have anticipated, but also longer than i would've anticipated, so we said let's pick this up and take a hard look at it. in terms of what to expect, we put up the bogey of saint roughly three months to get a clear picture on this. what i want to make sure is that we have success learning from our clinicians and practitioners on the ground in spokane such that they become advocates as we go to columbus and back to walla

walla to make sure we are building a coalition of practitioners, nurses, doctors that they end up being advocates for the continued expansion of the effort. i do not have any additional news to report to you all. i know you all sent a really helpful, robust letter down where you are asking us to lay this out in writing, which we are in the process of doing now, and we will get that to you forthwith and keep an open line with you as we run this review. >> i think you for doing that and for being here today. mr. chairman, i apologize for going over and i go back. >> thank you. appreciate your attentiveness to the time. i doubt call on chairwoman brownlee of our allison committee. five minutes. >> thank you, and welcome

secretary. i have great confidence in your leadership and look forward to the work we do in the 117th congress. i'm going to try to get four questions in. we will see if it works. the first question, which i asked during a subcommittee meeting last week, i want your assurance you will fully implement the act that was passed last year. sec. mcdonough: you have my assurance. >> terrific, and i know from our conversation you are working really hard and doing a lot around sexual harassment and assault within the v.a. can you tell me how do you plan on every v.a. facility across this great nation how you are going to hold each facility accountable so that we truly get to a zero tolerance and weeded out of the system? sec. mcdonough: it starts by

mike medication from the sec. slot, and i have started that from day one, and i have continued that on a regular basis in my public communications as just now in my opening statement and internally making sure that in each of my interactions with the workforce that i am communicating this clearly. third is making sure that our internal governance agencies and organizations understand that this is a priority and they help enforce it, and importantly that people who feel threatened or harassed understand there is a place for them to go to to be heard and be heard in a way that is respectful, does not be traumatized survivors -- retraumatize survivors and make sure that there is a place they can go to and follow through. on sexual harassment, on sexual abuse, but then across the board on accountability measures, so

those of the ways. then i will have to get on the road, which i will start doing relatively soon to make sure i am getting out there and underscoring that not only do we have to create this climate of hospitable climate but also we recognize the very simple fact, our diversity is our fundamental strength. that is why the veterans look like our military force, because of how diverse we are and we have to continue to recognize that, invest in it, and protected. >> thank you for that. that will perfectly lead into my next question. in your opening comments you talked about data, science driven decisions, and i have reintroduced my bill, the every veteran counts act, which will direct the v.a. to conduct a national survey of veterans.

this would be for the first time in more than 10 years in order to ensure we have an accurate understanding of the veteran population and emerging needs. we cannot meet the enormous challenge of a diverse patient population without that data, and right now, 2020, 22% of the total veteran population represents diversity and that will be 35% by 2040. this is critical. the senator as agreed to work with me on this and lead the bill in the senate, but we have to get this data accurate, and this is an area where we do not. not only does the v.a. depend on this date up other agencies as well. i hope we can work on that together and would like to see. great, excellent. last question. i am sure you are aware of the

enormous backlog within the national personal record center, and i think they are trying their best to catch up on this, but based on the response that i have received it does not seem to be an acceptable answer to me, and i understand it is a very big challenge, but this backlog is going to hurt our veterans, future veterans tried to get benefits and it hurts folks in the pipeline right now. i am just curious to know how you are going to wrestle with this within the veteran community? sec. mcdonough: thanks so much for this. you have raised this with me, mr. bost, mr. tacoma. it is crazy that we have not gotten the vnrpc and the folks

who work in conjunction in the archives folks at college park have not gotten them vaccinated. i am using my authority. i said let's get these guys vaccinated and get them back to work. i am struck -- that is the first thing. let's get them back to work first and foremost. second is let's get those records digitized so that we are not stuck in this place again. i talked to the archivist just the day before yesterday on this. you will have given us money both in the omnibus last year and we will have access to some money in the american rescue plan to allow us to get the stuff digitized so it will move more quickly. let's get people back to work.

we have the vaccines to do that. we have signed all of their paperwork and hopefully we will be getting some shots in arms within the next couple of days. >> thank you, mr. secretary, and i yelled back -- yield back. >> --, you're five minutes. i call on you next. >> thank you, chairman and ranking member for holding the steering today. thank you secretary mcdonough for your testimony and welcome. i met you at the white house in february of 2015 so it is good to see you again. i look forward to working with you on behalf of our country's veterans. before i get into my questioning i also want to recognize an important veterans administration responsibility in the island nations of micronesia

, the republic of marshall islands. these assisted states are affiliated with the united states and are among the closest neutral security alliances between the united states and any nation. copa enables qualified citizens to enter into united states military service. [indiscernible] higher per capita than any state in the union. serve with honor, suffered casualties, and were alongside soldiers in afghanistan and iraq. some of these veterans returned from service disabled, still injured. these allies have erred and are morally entitled to via services not easily provided to veterans residing outside of the u.s.

despite some of the remarkable and resourceful efforts of v.a. employees to extend the reach to the v.a. in the fas by any means. we need digital technology and intensification of internet-based support for health care services, and i am happy to see that you have touched on the use of technology in response to covid-19. hopefully the v.a. will also continue to leverage new technologies post pandemic to address the needs of veterans both in the fas and territories. can you confirm each year and now v.a.'s commitment to veterans from associated states? sec. mcdonough: i can. yes. >> thank you. at what plans do you have to address the needs of veterans in remote areas such as the other territories. other than telehealth and

technology are there other resources v.a. can enact to serve the whole community? the director of the v.a. pacific island health care system suggested in a recent interview that he got to work with dod and possibly share certain resources. do you intend to explore resources like interagency cooperation? sec. mcdonough: thank you very much for the question. the short answer is yes. i would be happy to explore the kinds of interagency cooperation you are talking about. i think there is already as we watch efforts, and they said as they are, to increased access to vaccination in american samoa, the cooperation between v.a. personnel and local health officials is vitally important

to our efforts. also to expend care, and both of the steps on top of access and use of telehealth platforms, which have exploded during the course of the pandemic. i think there are important lessons to draw from this experience and important lessons that may allow us to expand this more aggressively. the short answer to all of that is, yes, and all of the above. >> thank you, mr. secretary. mr. chairman, i yield back. >> thank you, representative. i recognize representative lamp -- lamb for five minutes. >> thank you. on the topic of archives and military records i want to commend you, and in particular your department for the

intention they showed to this. that reflects well on your early tenure. thank you. on another topic, i want to address the issue of the collective bargaining rights and union rights of v.a. employees. they were blatantly disregarded and dishonored during the previous administration. i can't at this with a strong belief that the best way we will serve the mission of the v.a. and taking care of the veterans is by taking care of the people whose job it is to actually take care of them. the anecdote you gave in your opening was very powerful. it was really about the employees of the v.a. and how they treated his father. the way we make sure that happens is to make sure it v.a. employees themselves are treated respectfully and humanely and with the professionalism they deserve.

i was happy about president biden's executive order and for those who did not see it, i want to be clear. it is the policy of the united states to encourage unit organizing and collective bargaining and the federal government should serve as a model employee. in that order was issued on january 22 of this year. i know it is not been a longtime , but two months later we still have in my state of pennsylvania a v.a. in the city of philadelphia where union officials have been offered a conference room, where before the trump administration they had multiple offices to do their work. we strive union organizing officials whose job it is to represent workers doing their representation on their own child at a cost to themselves, not even for free, because their representation time as not been

restored yet by the local v.a., so the impression that are left with is the v.a. on the ground is dragging their feet in implementing president biden's order. if this was some sort of new right or new set of working conditions you might be able to understand why two months would be needed, but i think the frustration i get from v.a. employees is this has been outright for a long time. we bargained office space a long time ago. we bargained official time a long time ago. we just want to restore it to what it was before trump, so why is that taken so long? what is being done to implement the executive order, why it is taking so long and give us your commitment that you will try to speed these up and show employees the respected urgency they deserve. sec. mcdonough: on your last point, i have got that.

i will dig in on that. there will be announcements that we are taking steps as it relates to certain pieces of this in the next days and weeks. on the question of office space, i will take and follow up on that. if you have other specific places that you want to highlight to our attention, please do so. and we sent out that communication in early february, so i will follow up on that. to your broader point, i have the same view you do, which is that i believe that a unionized workforce is a strong workforce. i think that collective bargaining is a powerful tool for a strong workforce, and the evidence of this is manifold. the evidence is the performance

during the course of the pandemic and the stories like sean kelly sent tim. -- sent in. that is why i included the section of the letter as i did in my remarks. it says as much about the way our workers treat our veterans with respect that they do is a very powerful thing, and at the end of the day i have made a commitment in taking this job that i will make every decision based upon whether that increases access and improves outcomes for veterans. i see questions around labor-management relations in that same framework, and we will be making sure we both make those decisions and implement them consistent with empowering a workforce that is our number one asset as we confront these challenges. >> i thank you for that, and i just emphasized that you are dealing with a workforce that

has done some heroic and incredible work, particularly within the last year, but they feel mistreated and unfairly treated. so, thank you, i look forward to working with you. i yield back. >> thank you, representative. i call upon representative bergman for the next five minutes. >> thank you, mr. chairman, and secretary mcdonough, it is good to meet you. since time is of the essence let me get to my questions. i am very concerned about the impact the pandemic is having on veteran mental health and suicide. because of reporting lacks of the annual suicide data reports contain information from two years ago. that means we will not have 2020 suicide statistics until 2022.

that is way too long, especially if urgent action is needed now. how can we make that information more timely? what metrics are you tracking in real time to determine the mental health effects of the pandemic and what are those metrics telling you? how soon and how accurate? sec. mcdonough: so, the reporting like on overall numbers is maddening. i agree with you. this is part of our overall data strategy is to figure out how we go and find and marshaled the data that we do have and get it consumable in a weight that informs policy now. and importantly, in a way that helps veterans inform the decisions that they make about their incremental training dollar or how they choose to engage mental health service.

one is we just have to make the data more user-friendly. two is we have a lot of data that comes out of the national strategy from 2018, where frankly -- we do two things in the program that a very important. we draw and constantly update data at about against 61 measurements for veterans that together paint a picture of what to worry about in terms of at risk for suicide. one is we tried to get a picture of regular -- as regular as we can of who is at risk and we try to stay in touch with those personnel and get them into services. and so -- >>

>> if i might, mr. secretary, you hit the nail on the head. before we talk about personnel records and all these things, this is all about the individual and i know your working, and i would like to roll that into my next question. i spearheaded the improve act, which would increase support to community organizations, and that is the key to preventing veteran suicide, especially among the 14 of 20 states that are outside the v.a. system. are you able to give me a commitment that you will implement the improve act, and how do we explore unexplored areas for reaching out and contacting those veterans who are not within the v.a. system, get them the help, and get them in?

secretary: section two of one gives us new authority to make grants in communities, so we are spending a lot of time on this because we have not done this kind of grantmaking yet, so we are also talking closely with senator boseman about this, and senator kester, who i think worked with you and others on these provisions. we are aggressively trying to put -- get that grantmaking into the field. there are some steps, frankly, the, that we have to take now to make sure we do that well so that we are not kind of tripping over ourselves, but i do think that among the most important new authority as you have given us, which is our ability to get into the community that knows these vets and have a way to reach them in their community, so if there is some reason, be at that stigma or some other reason -- a lack of knowledge

about what is available at the v.a. -- if the community knows that somebody is at risk, if somebody is feeling down, if there is stigma associated with them getting treatment, that the community is helping address that. there's no question that is a big piece of the puzzle, i believe, but at the end of the day -- yeah. >> i'm a marine, i like to stay on time. you offered about hitting the road, so in a perfect world, i would like to hit the road with you next fall, and we are going to go to the iron mountain va hospital because all v.a. hospitals are not alike. there's a smaller hospitals. we do it on a thursday. we work through the western upper peninsula of michigan and get down. i will play stillwater in

football on friday night. and saturday night, because sega's will play. how about that? >> i love them both. >> will wager a beer on that. >> or a couple. >> i go back. >> thank you for being such a stickler for time and mentioning beer. i will now call on the vice chairman of the full committee, also chairman of our economic opportunity subcommittee, representative leven. representative leven: thank you, mr. secretary, and thank you, mr. chairman, and i have to follow that by welcoming the la jolla v.a. and to our beautiful southern california coastal communities. we cannot wait to have you. it is very exciting to get to work with you, and i appreciated

your call recently. a few questions for you. as you know, we have passed some major bills at the end of last congress, beginning this conference. the isaacson and rope -- row act provides much-needed benefits for veterans. i'm eager to work with you to implement this legislation, particularly provisions that improve the oversight of recreational institutions and establish new homeless resources. i'm also thrilled we were able to establish a rapid retraining program for unemployed veterans earlier this month and as the chair of the subcommittee with jurisdiction, i look forward to holding oversight hearings and following up on implementation of these measures later this year. in the meantime, it would be really helpful if we could have regular progress updates from you and your team. i would like to ask -- can you commit to sharing such updates on implementation of the

benefits package and the american rescue plan on at least a monthly basis to the committee ? >> i'm happy to commit to the regular updates, chairman. i guess what i would like a little flexibility on, is that a monthly or bimonthly thing? let me take that. i promise you regular updates. let me work through the timeline of that. i feel on the hook for the reasons you just said, which is you all have given us a lot of resources. these are taxpayers' resources. we are on the hook to be very transparent and clear with you about our spend plan, and ultimately for us, not to be measuring what we are putting in here, but measuring what vets are getting out. that's the name of the game, so i commit to the regular updates. i will be careful to not say monthly yet. i may come back to you by the

end of the week/early next and say monthly is ok, but before i put this on my team, let me make sure we can do it because i don't want to make a commitment i cannot live up to. >> thank you, sir. another of our priorities is upgrading the v.a.'s archaic i.t. system. i had a chance to visit muskogee and see the call center using some very antiquated technology. v.a. recently signed a contract with accenture to do a lot of this work but has not provided us with a lot of details on the contract and larger project, including a 10-year cost estimate. i appreciate the v.a.'s arranging everything to share more details with staff and look forward to receiving a readout. ongoing updates on this issue would be really helpful to us, especially given the track record when it comes to v.a. implementation modern optimization projects. same question -- can you commit to sharing these updates with us

on a regular basis? secretary mcdonough: yeah, i'm happy to. the single most impressive briefing i've had since i got here was by the head of our education program. she is an unbelievable talent, and i'm happy to commit to the regular updates there, too. representative levin: thank you. i was concerned to learn v.a. will and practice of rounding out, which allows students to round out their schedule with nonrequired classes to receive full-time status. while this decision was made under your predecessor, if it is not reversed, there could be dire consequences, reducing benefits for thousands of benefits, impacting their ability to meet living expenses, and as a result, many students may have to take out additional loans or drop out of school

altogether. the question is can you commit to reassessing this decision of ending the practice of rounding out and taking necessary action that protects veterans from financial harm? secretary mcdonough: the short answer is yes, and the longer answer is this is the first i'm hearing of it. i just want you to know that this is the first i'm hearing of it, so i may be coming back to you and saying that i don't have access to it, but if i do, i will. representative levin: thank you, sir. from what i understand, it could be a really big deal for our students later this year. like the general, i want to be respectful. i'm out of time. i yelled back. chair: so far, i think vice chair of the committee has been the first and only one to stay on time. a role model for the rest of the committee. mr. banks, your next with five

minutes. representative banks: thank you, chair. i will take that as a charge. i agree with the ranking member that a strategic review of the hrm is the responsible course of action. i would like to offer three recommendations for you to strengthen the program based on watching it develop over the last four years. first, it may need more requirements for strategy. the doctors in the veterans they serve the customers. oehrm is the implementer. when vha is not given what it needs or when oehrm does not listen, result have been poor. second, we have to stop tasking cerner outside of core competencies. it cannot and should not be

expected to integrate all of v.a.'s symptoms or fulfill every technological need. third, i think the phr -- the ehr has not proved its viability until performance improves in spokane. cost estimate and schedule have to be revamped. i'm wondering, do any of these observations align with the input you are receiving in your initial assessment that you are being briefed on by your team at this point? secretary mcdonough: yeah, in candor, they do, except the last sentence you read or stated. i have not kind of put that on the table, but everything else you said does, and, you know, as a general matter, i think that

we just need more in the execution of the program so that, as you say, the vha customers have not only a big seat at the table, but also kind of an ability to sit with people at their shoulder to test and run this thing and that we are not letting any one piece of a multicomponent effort here take an onus without listening to the executors. at the end of the day, this is about service provision and outcomes for the vet, and that has to be what drives it. the best policy for that right now is making sure practitioners understand what it means and see the benefit. if they don't, then we will be in this box for a long time.

>> i appreciate that. i have been concerned about the ehrm spend rate for some time. spending is supposed to peak this year at $2.6 billion, but the paste of medical centers will not peak until years from now. do you agree that we need to slow down the spend rate? secretary mcdonough: what i agree to is to take a hard look at that question. one of the things we are learning is it does appear to be requiring a lot more people on the target in spokane, at least right now, then -- as i read the planning than the planning anticipated. the reason i'm wondering about the spend rate is if there is more people on and time on the

target, i wonder about what that means for the spend rate. maybe you and i are saying the same thing, but i agree with you that we have to figure out precisely what the use case in spokane is telling us and what that means for the larger effort. my commitment to you is to be very transparent with you on this and make sure we are operating off the same data and trying for the best experience we can. representative banks: let me quickly turned to my last question. i want to talk about spokane for a moment. the effort is evolving. first, there were tiger teams. then there were work groups and an advancement plan. are we going to see changes at the end of the strategic review, or is there a different timeline? secretary mcdonough: is your question are we going to see changes to the ehrm, meaning the

software itself, or what do you mean? representative banks: the timeline for the strategic review -- it seems like it continues to evolve for the actual strategic review. secretary mcdonough: i see what you are saying. i think we can get the kind of joint this -- jointness that we need where customers are informing the experience. the real strength of ohrm's understanding that additional requirements mean additional costs, so we have to balance those competing priorities to get the best of both and to use the lessons of spokane to make decisions about the further goal lines. i don't think that means we

fundamentally change the underlying program in spokane. it tells us a little bit about what we need to do as we are going live in the subsequent places. i think we should be able to draw some conclusions about that in that 12-week timeline, but at the same time, if we find something that tells us what is going on here, i will come to you guys in complete candor and transparency until you what we need to do. representative banks: thank you. my time long ago expired. chair: yes, i noticed mr. banks. -- i noticed, mr. banks. >> thank you, chair. secretary -- mr. secretary, it is an honor to be with you. thank you for your service and we appreciate you being here with us today. i chair the committee on oversize investigations, and we

have had several hearings on whistleblower protection at v.a.. we know we have heard from the ig over time that there is a culture of retaliation within v.a., that v.a. has floundered, in their words, to set up the office of accountability and whistleblower protection to ultimately protect the individuals who are working in the system who come forward with , you know, claims of waste, fraud, and abuse, and better ways that we can ultimately serve our veterans in the end. i wonder how much you can make a priority of ensuring that the v.a. is going to protect the whistleblowers in the agency and make sure they know their rights and know how to come forward with this valuable information. secretary mcdonough: i have been talking to the workforce since i started. i indicated in my opening remarks, i have met with the heads of each of the accountability agencies and

organizations inside the building. you may have seen earlier today, the president announced his attempt to nominate a leader for the oa wp, for example, who had great experience standing up effective organizations, including a new independent ig in the context of the philadelphia school district, and somebody with a proven track record on accountability matters and that at the end of the day, i've said two things about the agency here, which is one is the lifeblood of a well-functioning agency is the free flow of good information. by "good," i don't mean only information that tells a positive story. i mean information that tells us what is going on. the free flow of that information is a prerequisite. the second is any impediment of the free flow of that information including retaliation against

whistleblowers, including ignoring requests from the inspector general -- those things will not be tolerated here ever, so i don't know that there is a culture that might mention to you of retaliation, but if there is, we are going to change it. that might take some doing because the free flow of information that tells the accurate story, good or bad, is what we need to succeed. we owe that to you. >> i appreciate that commitment. recently, chairman takata and i sent a letter to you that outline some egregious cases of whistleblowers. we have not received a response yet. i'm just hoping i can get your commitment to get a response back. secretary mcdonough: you got it.

representative poppa's -- representative pappas: thank you. an issue that has been brought to me by my state's veterans cemetery in new hampshire is that we know that there are many that serve in our national guard who served alongside active-duty counterparts and have been on the front lines of fighting covert over the last year, but many of these guardsmen and reservists often face difficulty in receiving parity in terms of benefits. one of the bills i introduced would ensure state run veterans cemeteries will not jeopardize federal funding if they choose to enter certain honorably discharged members of the guard and reserve and their spouses. this came up at a hearing last year. i was dissatisfied with the response of the hearing, which said the move would diminish the distinct honor that those

veteran service members who have earned their real rights received, so i'm hoping you might be able to reevaluate this position to take a look at this legislation and see if there are ways we can allow state-run veterans cemeteries to make this decision without losing federal funding. secretary mcdonough: i'm actually familiar with the issue. i had a discussion with our team about it last week or the week four. we are taking the initial steps which is to go out and ask if there are other states who have a situation or have made choices similar to one that new hampshire has made. we will get that information, and my commitment to you is to stay in touch with you on it and to make sure that we in the first instance have the information to make any decision, but in all cases, you have my commitment to take a look at it, to be transparent with you on it, and the first

step on that, if we have not gone out with that rfi, we will be shortly. representative pappas: thank you. chair takata: thank you, representative pappas. you are ahead of the game here. mr. roy, you are recognized for five minutes. mr. roy? if mr. rory is not available, we will go to ms. luria. representative luria: thank you for appearing before the committee today. i have seen and heard the same

things from my employees here at the hampton v.a. management is refusing to abide by president biden's executive order, so i'm just asking, and hopefully you can reiterate some of the conversation that you will work with your offices to make sure the president's executive order is complied with in the order will be fully implemented. secretary mcdonough: i will. representative luria: thank you. i really want to take care of our veterans, so that is really important. one of the things that we spoke with that was really challenging for some veterans was claims for military sexual trauma. you will soon be relieving -- you will soon be receiving a

letter from myself and several colleagues on both sides of the aisle with several policy recommendations we have compiled collectively from our work the last few years in learning from veterans who have experienced some form of sexual trauma and just experienced several challenges in trying to file claims related to that. i just wanted to speak to you about that and also ask for your commitment in helping deal with these particularly difficult and sensitive situations to actually make it easier for victims to receive the care they deserve. secretary mcdonough: one, you have my commitment. two, i look forward to seeing a letter. we are working hard right now at policies and procedures on this question, and that is because, three, this is a major priority for me and very important signal

to address many of the things that chairwoman brownlee raised, which is an overall culture of hospitality, hospitableness to all of our veterans. it comes from guidance from the president -- we have been clear on this, and it also comes from meetings from secretary -- meetings with secretary hoskins, whom i have worked with for a couple of years. he and i have added a couple of meetings, including with survivors and making sure one thing i take from those meetings is the fact that our survivors too often are re-traumatized by the process of filing claims, seeking care, and we just have to get better on that. not only that, i think we and

dod together and jointly -- i think you know well from your own career -- we have to get better jointly at this question of both stopping assaults, harassment, abuse from happening in the first instance. if it happens, making the abusers accountable, and then, as important as anything, investing in protecting and helping heal the survivors. that is a continuum of challenges that there's a lot of that we can do and we are doing in a joint way with dod, but if we do it together, it will be much more impactful.

>> i really am appreciative that you have put so much thought already on the issue. i look forward to working with you to help improve this issue for our veterans. my last question is the c&c exam inventory backlog. normally, we would have approximately 140,000 exams in process on a normal basis. with covid, we shot up to about 350,000 in a significant backlog. one of the challenges i have from leadership is that they have not provided a written plan or really a timeline. they are in vicious to have it done by the end of the fiscal year, but it is hard for us to stand as a committee if you can remove the backlog.

i know my time is expired. i wondered if you had any feedback quickly on that. secretary mcdonough: i saw your letter that came in before i came in office. i spent a lot of time with the letter last week. i don't know if it has come to you, but i have to refresh my memory on just how much data and timeline we gave. we can follow-up separately. if the letter is wanting in some way, we can follow up on it. i want to get to the meat of your question, which is you want us to show you a plan, and it's a fair question. my only question back to you is have you seen the letter, and is the letter lacking in the kind of data you're looking for? >> i have not seen the letter response yet. i look forward to your response

and make sure we reach out again. secretary mcdonough: it was you and i think as many as 10 or 12 of your colleagues. we had a fairly meaty response, but that does not mean it was meaty enough. in her cases, i will take the request seriously. representative luria: thank you for your support on these issues. i yelled back. chair takata -- i yield back. chair takata: i represent -- i now recognize representative dr. murphy for five minutes. represented of murphy: i want to thank the secretary for being here today. i worked at a veterans hospital during surgical training for just taking care of veterans for 30 years here in eastern north carolina and actually continue to take care of them. i love veterans. in my district, we have the most veterans of any district in the country.

they love coming east, and they come to camp lejeune and all these places and stay there, so there's a very large local population. i want to just ask about this -- you are in a hard job. everybody that has preceded you has made promises about accountability, about this, and about that, and unfortunately, it just does not seem -- and this is 30 years of experience of me working with the v.a. -- it just does not seem we have gained any traction. this is not particular to any fault of your own, but i will attend to that, does not buy it with me. when i ran a surgical practice, i demanded accountability. our customers are veterans. these are the brave men and women who have sacrificed, at times the ultimate sacrifice,

their lives for this nation. perhaps i am just being a hardass as a surgeon, but are v.a. needs accountability, and that starts with you. i am going to get on the phone as soon as i hang up and speak with the director of the v.a. in fayetteville, who accompanies our area -- which encompasses our area, and we are going to have a heartfelt discussion. we had won three weeks ago and i have seen zero results. i appreciate the problem with the record backlog. i ask that you hold everybody accountable, all the way down to the county, where we call and nobody will pick up the phone. we cannot do this to her veterans. they do not deserve this type of treatment. i appreciate your willingness to do this, but i also want to hold your hands to the fire that you hold each of our veterans

agencies close to being responsible. i know it is hard to recruit for the v.a. but i don't live in the world of excuses. i live in the world of can dos. i would like to hear that from you. i will give you a minute to respond. sec. mcdonough: can do. i agree. rep. murphy: that's all you got? sec. mcdonough: i agree with everything you said. you say can do, i can do too. i am accountable to all the people who work here, to the president, and to the vets. i make every decision based on increased access, better outcomes, and that means holding people to account when that does not happen. i don't know much about you other than you went to a place where someone very important to me also goes. the but i have heard enough from you to understand that you are kind of a no bs person, a can-do

person, and i will tell you i agree with you. you can hold me accountable all of that. rep. murphy: and you are in a hard job. but it requires accountability. i am glad to hear you are going to be out and about. i look forward to you visiting eastern north carolina and our district, because we are going to ask hard questions to rva's here. i appreciate you serving all of our veterans, regardless of their skin color or any of the other silos we want to put people in. they are veterans first, and that's what we owe to them. we owe to them service. >> i yield back my time. >> thank you, dr. murphy. i never recognize ms. underwood. rep. underwood: thank you, mr. chairman. i want to congratulate mr.

secretary. sec. mcdonough: thank you. rep. underwood: as a member of this committee and this nurse, i want to invest in evidence-based suicide prevention initiatives. one significant intervention to save veterans lives is lethal means of safety, which has been proven to reduce the risk of suicide. i am encouraged that the v.a. has implemented lethal means safety training for some employees, but for all others, that training is optional. voluntary completion rates are strikingly low. this is concerning because of the importance of maintaining parity between the care that veterans receive at v.a. and the community. we know that requiring these trainings is necessary. while the completion rate from editorial providers is at 80%, only a few hundred, like very

few hundred community providers nationwide have voluntarily taken the training. so i introduced the legal means safety training act to make sure that everyone caring for and regularly interacting with our nation's veterans is required to take this lifesaving training. mr. secretary, will you look into actions that you can take with your existing authorities to further expand mandatory legal means safety training and make sure that anyone caring for a veteran is prepared to have a conversation that could save the life of a veteran in crisis? sec. mcdonough: yes, that is an offshoot of a question the chairman asked too, and i will absolutely look into this. rep. underwood: thank you, mr. secretary. they are more important than ever during the pandemic, which has led to significant higher rates of suicide ideation. i look forward to working with you on this priority.

the covid-19 pandemic has also led to historic job losses. the unemployment rate for veterans was 5.2% in february, more than 2% higher than the rate in 2019. we need to ensure our veterans can find high quality employment opportunities. i am encouraged by models like the program at a laboratory in my district. it creates career pathways in industries of the future. this model can also be used to expand employment opportunities in careers like mental health, which would also address a glaring need at the v.a. a report found severe occupational staffing shortages for mental health professionals across v.a. facilities, including psychiatrists, psychologists, and nurse practitioners specializing in middle health and substance abuse. -- mental health and substance abuse.

you described the v.a.'s strategy to address workforce shortages, including funding needed from congress to carry out such plans? sec. mcdonough: we don't need additional funding or authorities at the moment, but i am happy to hear that you are willing to hear it. the first is to retain the talent we have. we have some excellent talent. the second thing is to make sure that we are recruiting new talent to that pool. many of the things we have talked about already in this conversation, including making sure we are treating the workforce, including the unionized workforce, with the respect it deserves, making sure we are having the kind of work atmosphere that is important and critical to maintaining and attracting this kind of talent.

third, making sure we are using relationships in the communities to share best practices and deepen networks and connections among v.a. and non-v.a. providers. those are some of these steps we are going to take. in terms of the lab efforts, i am going to talk to our team about that. there is a range of programming we have through our education programming to train and -- train in high demand job areas. your idea of ensuring that we do that as it relates to mental health and medical professionals generally is a good one, and i will make sure we are back in touch with you on that. rep. underwood: i am pleased to hear that. we know there are 2 million

women veterans in our country, the fastest growing group of veterans. but i want to make sure pregnant veterans receive the high-quality support they need, given our country leads the world in maternal mortality. we have a bipartisan protecting moms who serve act to support the v.a.'s paternal care coordination program and to commission the first-ever comprehensive study of maternal mortality, morbidity, and disparities. i wonder if you can help to save mom's lives and eliminate infant mortality. sec. mcdonough: i am committed to do that. rep. underwood: thank you. i yield back. >> thank you, mr. underwood. i recognize mr. nails for five minutes.

rep. nehls: thank you, chairman. what an honor to be here, and mr. secretary, congratulations on being the secretary over such an important area. our veterans, taking care of our veterans. i had a conversation with a few weeks ago, and i believe you stated this was one of the greatest honors you could have ever received, to be a secretary over veterans. i truly believe you're going to do a fantastic job. i believe your heart is in the right place, and i am honored to serve on this veterans affairs committee. earlier, just --the chairwoman over dama had a hearing last week with the v.a. and we were talking about these -- we had a

casual conversation about all of the disability exams, the backlogs. the v.a. said they are going to do everything they can. the goal and objective is to reduce these backlogs to 140,000 by the end of the fiscal year. i share the same concern as she. there did not seem to be a written client. i am not here to make things difficult for anybody, but if you could really look into that issue and make sure there is a written plan and share that with chairwoman elder rea so we can make an informed decision, i think that would be a step in the right direction, but i want to congratulate you on your appointment. what a great honor it is. what a great honor. sec. mcdonough: i thank you, mr. nehls. i enjoyed our conversation. we agreed to disagree on the packers and vikings, but as a general matter, i think we agree

on the fundamental honore does to serve in this job and to work together. i will absolutely be back in touch with representative luria and with you on the question . i am hopeful that the document i saw and signed sometime in the last week -- it all runs together -- against answer that, but if it does not, i will continue to work with you on it. as i said in my opening statement, i respect and appreciate the role that you play here, and the free flow of information and ideas among us is critical to our success and ultimately critical, most importantly, to the vets getting what they have earned. rep. nehls: thank you, and i am going to finish with this. i am going to be leaving in a few minutes. i have a funeral to go to, a veteran, 80 years old. the senior advisor at the

sheriffs office, an old army officer. we have his funeral in a few minutes, and his wishes were to be laid to rest at the houston national cemetery. he is not being cremated. i get notification from the family that there is a two week backlog. i guess this gentleman is going to have to sit in the funeral home for two weeks until the houston national cemetery can, i guess, catch up. i assume it is related to covid, but i am going to look into it. i just want to make sure that if there is an issue with the houston national cemetery, somebody should be sending this information up the flagpole, because a two week delay -- i mean, this gentleman is not being cremated. he is going to be sitting in a funeral home for two weeks. anyway, i thank you and look forward to working with you. god bless you on this assignment. i know you will do great things and be in the history books. sec. mcdonough: thank you very much. do you have my cell phone

number, so that whatever you learned today, please call me? if it is something else, please let me know. thank you very much. rep. nehls: yes, sir. god bless. >> thank you, mr. nehls. i now recognize ms. frankel for five minutes. rep. frankel: thank you, mr. chair. you, mr. secretary. congratulations and good luck. i want to talk to you about student centers, which are not under the offices of your department, the veterans administration, but ordination within cooperation with -- coordination with an cooperation with is very important to their success. this helps veterans transition from the military into school life. it's moves it out.

-- it smooths it out. 60% of veterans go to college now, and there are about 750 thousand student veterans on about 1500 campuses. i learned this yesterday from the student veterans of america, which is a great organization. if you have not met with them, i would suggest you do so. one thing they told me, that 90% of post military jobs are now different than what they had in the military. that is why college or vocational school is so important. one of the things i felt was quite eye-opening is that the student centers, they increased -- that veterans who have access to them, it increases graduation by 10%, and it counts itself as an orientation to let veterans know about that. that is about a 40% increase in

graduation. when you look at the amount of money we pay for the g.i. bills, something like $13 billion last year, think about that, the savings. almost over $2 billion saved by having veterans build these centers. one of the things that i did here in talking to the students, the student veterans, is a request to have really good cooperation with -- especially with the local v.a.'s in their area, because coordinating the health services for the veterans is very important. i guess i am going to ask you a question, and i don't know whether you are familiar. could you go to the center and see what they are about? sec. mcdonough: i am familiar with the centers.

i am planning to go to one on a trip in about three weeks. i am also very familiar with the student veterans' association, and i spoke at the conference, but several of their alumni network for the v.a., including in a bunch of positions i rely on directly, so i am familiar with it. i think it is a good idea. i look forward to learning more about it. i will say that now generations and generations of veterans and their kids and grandkids are on a much different path as a result of different iterations of the g.i. bill. i think it is one of the great iterations that has paid dividends for the country over time. i am very proud of the programming on that, and i look forward to working with you and the committee in ensuring that we make maximum use of that effort to continue to tap this

enormous human resource that is our veterans. rep. frankel: thank you very much. mr. chair, i yield back. >> thank you. i now recognize mr. mann for five minutes. mr. mann? rep. mann: thank you. mr. secretary, yesterday it became apparent that the v.a. does not have a true end to end medical supply chain. one of the major i.t. programs is software that would be beneficial to have, but it won't automatically print or complete supply chain with the visibility and connections to all the different silos. how will you make sure the v.a. properly addresses the root causes of spending billions of dollars on i.t. systems that don't solve the underlying issues in the supply chain? sec. mcdonough: thank you very much. i read a bunch of the record

from your hearing. i thought it was really helpful. i appreciate you having had that hearing, one. two, i think that, as with every health care system in the pandemic, he really struggled in the early days on our supply chain in the pandemic. the reason i raise that is i think the experience of it both makes your point and also suggests a really clear path forward, but of the beauty of being an integrated system and the necessity of improving cooperation and court and communication across -- and communication across divisions, because of the dramatic increase in demand on things like ppe as a result of the pandemic. and because of our ability to

use predictive analytic tools to get our hands around what to expect and where to expect it, i think we have begun to see the system begin to function like a well-integrated medical system. so, i feel much more confident about the overlay of something like demos, which i think you are referring to, and using that proven logistics system coming from dod, based on the experience of the pandemic, i feel much more confident that that experience informs our ability to use it effectively. but the other thing that is going to be required is really aggressive oversight from you all of the type that i saw -- i saw it up close and personal. i went through the written testimony yesterday that you guys conducted. my commitment to you is, a, i

recognize precisely the point you are making, which is the best software in the world will not make a broken system fixed, one. two, your oversight on that is going to be critically important, so i will see in very close touch with you and be transparent with you on what we are learning. rep. mann: thank you, please do. second question, one of the most common barriers we are hearing about when it comes to ending veteran homelessness, an issue i care a lot about, is a lack of affordable housing. economists believe the economic downturn associated with covid is going to worsen that problem. would you support a bill to reauthorize a program that allows the v.a. to rent or sell properties that the department has acquired as a result of defaulted home loans to help increase the supply and lower our homelessness among veterans?

sec. mcdonough: it sounds logically like the right answer, but rather than give you a commitment right now, let me take and study it and be back in touch with you in shorter over on the question. -- short order on the question. i am in conversations right now about our efforts, and with the white house and labor and education and treasury, ensuring that we have coordination on all these questions, but on your specific question, let me study that and get you an answer. rep. mann: sounds good. thank you, sir, and mr. chairman, i yield back. rep. takano: thank you, mr. mann. i now recognize ms. slotkin for five minutes. rep. slotkin: secretary mcdonough, thank you for being in front of us.

you are a real doer, and the v.a. needs a dealer. and a doer with a heart. i am glad to have you in that seat. this is my first time on the committee. i was struck but i became a member of congress have everyone talking about veteran suicide. a time of vietnam veterans and their older years committing suicide. i looked at the data on your website, and it appears michigan has a very high suicide rates between -- high suicide rate. between 2016 and 2018, we increase our rate i 7.2%, whereas nationally it was only 2%. my colleague, representative bergman, invited you to michigan. we would love to have you come to those states with a particular problem with suicide.

do some listening sessions, come and talk to our veteran resource centers, and try to tackle the problem where it is most acute. sec. mcdonough: count that, happily. rep. slotkin: thank you, and we will take you to a football game. we've got better teams downstate. the other thing, my guess is part of the reason we have higher rates of suicide is we have a real problem connecting veterans to services that they qualify for, that they are -- that are available to them. they just don't know about it. i hear it from everybody. people want to know, how come i can't get veterans to reach out to them? how come there is this disconnect? some of it is no marketing budget for the v.a. programs, but some of it is the disconnect and not allowing us to have access to that veteran information. is there anything you can do very briefly to help us get to the programs -- get people to the programs that already exist?

sec. mcdonough: this is the holy grail, i think, and we are trying a lot of different things. we are looking at a pretty innovative effort, whereby as we are getting that's to come in for the vaccine, or as we are going to them, homeless vets, to get them the vaccine, where now you have expanded the authorities, as we have new vets who, maybe for the first time are going to say, i need the vaccine, we are going to take that target of opportunity, including that after we get the vaccination, you need to sit still for 15 minutes, to make sure we go talk to them during that period. we are having some success, but that is the example of the kind of thing we are trying to think about. we believe better participation in the v.a. is the answer to a lot of the challenges. i think that is a big challenge for us, and if we fix that, i

believe we will fix a lot of these other problems. rep. slotkin: i am glad you have paid attention to that, because there seems to be a massive disconnect. moving on, in my county, we have two of the big veterans cemeteries in the state of michigan, the seventh busiest in the country, great lakes national cemetery. i keep hearing about how the funeral and burial benefits for our veterans are not enough to cover the costs of actually being buried. i think the amount of money is up to $2000 you get as a funeral and burial benefit, but a funeral and burial with embalming and all the other things can be up to $5,000. if you could commit to just looking at that privilege and making sure it has kept up with inflation and all those other things, that would be a big help. sec. mcdonough: i will absolutely do that. rep. slotkin: lastly, as a cia

officer, i served three tours in iraq, and i remember living close to a burnt tent in this issue of toxic exposure. i know the chairman is focused on this issue, but i keep hearing these stories of people who have cancer, have some sort of problem, and they are fighting the v.a. to get the tests they need at the exact same moment they are fighting for their life. it is horrible, so this idea that there is not enough research on what toxic exposure has done to our veterans, i beg you to either get the research funded, we will help you, or please allow for those pre-existing conditions to be lifted so that. have to fight the system just to get a basic test -- so that folks don't have to fight the system just to get a basic test. sec. mcdonough: i will say two things, one in direct response to this, and i will go back to another thing. one, i agree with the sentiment,

congresswoman. two, we are not going to wait for this to come to us. we are going to go get it because i think the logic is powerful. three, we do have a trust question with the v.a., where people do feel like they have to fight to get hurt. -- get heard. how we fix that, including on toxic exposure, will help us fix this bigger problem of getting more people in the system. the last thing, and i know given your history in your own family come part of getting more vets in the system -- in your own family, part of getting more vets in the system is the transition on getting other vets out of active duty. i know that you and other members sit on the armed services committee, so you all helping us think through how to make better use of that, to make sure we are getting people connected to one another,

connected to the v.a., is going to go away long way. -- go a long way. we are dedicating time and resource to it, and we've got to do it right. rep. slotkin: thank you. i yield back. thank you, mr. secretary. rep. takano: heine recognize mr. rosendale for five minutes. rep. rosendale: thank you, chairman to cano. secretary mcdonough, thank you for -- chairman takano. secretary mcdonough, thank you for serving. my time is limited, so i will dive right into my questions. mr. secretary, do you believe the electronic health record modernization program and still be completed and fully operational in 2028, and for the 16 point one? billion dollars -- the $16.1 billion?

sec. mcdonough: i do. rep. rosendale: ok, i am working that down. do you agree the right course of action at this point is the focus on quality and functionality, with payments tied to completed metrics and the schedule adjusted accordingly? sec. mcdonough: i think i do. i don't entirely understand the second part of the question, but yes, i do think we should continue to make progress. progress should measure functionality, i.e., is the system giving us what we need, which is a better, more comprehensive, easy to look at the experience of the veteran of himself or herself, and should we continue to measure that? yes. rep. rosendale: what i mean by the metrics is, are they

achieving certain benchmarks, and the compensation for that -- should the compensation be measured there? sec. mcdonough: should we implement a basically pay-for-performance contract? as much as this is a specific contract question, i want to be a little -- i want to be a little dodgy here. i don't expressly know the contract provisions, but i can tell you that if our review shows anything to suggest that, the current employment of -- deployment of the system, or the contract requires us to move forward even if our practitioners are not able to use it to help vets, or it is

not increasing outcomes for our vets, i will be the first one back up there to say it is not working and we need to relook the whole thing. i don't think that is what we will find, but if we do, i will be the first one to say to you this is not working and we need to revisit the whole caboodle. rep. rosendale: ok. i'm just saying we have had time frames that have been delayed over and over again where they have not made those benchmarks. in the world i live in, you do not get compensated for a job that has not been completed, so when i am asking is that if we set these metrics, should not we be setting the metrics and awarding the compensation if those benchmarks are hit? sec. mcdonough: look, i mean, i totally agree with the idea that we pay for -- we should pay-for-performance, and i think that should go to how we procure technology in the united states government.

i have not looked at the specific contract here, and i don't want to get in trouble with lawyers on it, but the concept -- you are from my time, i am from -- you are from montana, i am from minnesota -- the concept sounds right to me. sen. rosen: bill -- rep. rosendale: i understand the v.a. is prohibited from providing abortion counseling, correct? sec. mcdonough: under current regulations, that is correct. rep. rosendale: yes or no, do you have any plans to alter or change this policy under the biden administration? sec. mcdonough: do i have plans? no, but is it available for us to change that? yes. as your question suggests, you also believe this is a regulatory matter. if we do choose to change it, change it would require public rulemaking and public comment. if i were to make that decision, i would do it in full light of

day and transparently talking about this with you at the committee, but i have not begun any deliberation on that. if i did, i would make sure you are aware of it. rep. rosendale: thank you so much. mr. chair, i will yield back the remainder of my time. rep. takano: thank you, mr. rosendale. i recognize mr. szabo on -- mr. sablan for five minutes. reppo some blog -- >> mr. secretary, thank you and congratulations. i am going to ask this question, and if we don't have an answer, maybe get back to us. but i wrote to you asking about that apartment's plans to vaccinate veterans mva staff in

their district. that would be northern marion islands and american samoa. we do not know the department has provided vaccinations in our area. we understand our local public health centers have used some of their allegations to vaccinate veterans mva staff -- and v.a. staff. we are not sure if the replenishment has occurred. we ask that you ensure the department moves quickly to vaccinate veterans in our district, and that the vaccine supplies utilize public health services are restored. sec. mcdonough: i think that is a reasonable request, and i will find out if the replacement has happened. i am under the impression it has, but i will find out to be

certain. >> thank you for that commitment. the comprehensive assistance to family caregivers is not available in my district of the northern mariana islands because there is no v.a. staff that provides support services. however, many aspects can be done online by phone or video application. only the initial home care systems and possibly the annual assessment require v.a. staff to visit the veteran's home. however, to reduce the risk and exposure of covid-19, the department is now allowing all home as it's to be done by videoconference or other -- all home visits to be done by videoconference or other methods. would you consider extending this flexibility be on the

pandemic to allow districts like mine to access the program? this is a place where you only have two staff, mr. secretary. we don't have a clinic, and veterans are being denied of the services they are eligible for. sec. mcdonough: thank you for raising it. i do think we need to make sure that we take a comprehensive look at all lessons learned from the use of telehealth during the pandemic's, to make sure that we establish that as a new floor and then grow off at that. -- off of that. as it relates to looking at the continued flexibility to use telehealth visits, it seems

to me to be a reasonable question, so i am happy to make the commitment to you that we will look at that and make sure we come back to you with our answers. del. sablan: thank you. your hawaii regional office will be very helpful. in february, mr. secretary, my staff was briefed on the department. the language directs the v.a. to increase access for veterans living in remote and underserved areas, and strongly urges an increase in the number of dedicated v.a. medical and mental health providers in those areas. in response, dr. adam robinson proposed we hire a practitioner that will travel and see

veterans and offer telehealth services in the area, and a psychologist or licensed social worker to provide psychological treatment. i ask you for your support of dr. robinson's efforts. this is an effort that is sometimes hard -- that sometimes starts and then goes away again. we have a nurse and an administrative person in my district, secretary. we need your attention as much as possible. thank you very much. sec. mcdonough: i will make sure i follow up with dr. robinson on this, and i think you're right to feel that. if you are speaking to dr. robertson, you are speaking to the department. let me follow up with him.

and i think what you are asking is reasonable. del. sablan: mr. secretary, mike my time is up, and i look forward to working with you. rep. takano: thank you, mr. sa blan. mr. trone, i recognize you. rep. trone: thank you. we are looking forward to working with you on improving outcomes for our vets. one of my biggest priorities is improving mental health care. this is taking a particularly hefty toll right now on our veterans. interagency collaboration is key on some of these most complex issues that face our vets.

we recently introduced a bipartisan bill, the behavioral health coordination and communications act, to address the challenges proposed by the federal agencies working off mental health and substance use disorder. we established interagency can occasion across -- communication across the v.a. how closely is the v.a. working with other agencies to improve access to mental health? sec. mcdonough: thanks. i agree with you that interagency coordination is vital here. we do have a series of interagency coordinating mechanisms to allow for v.a., for example, to work very closely on the issue in particular that you raise with samsa that hhs.

the best interagency coordination comes through efforts chaired and driven by the white house, and we have some of that here too. for example, with the prevents task force. but at the end of the day, as vital as interagency communication and coordination is, exactly what that looks like going forward is going to be driven by outcomes. as i have said, every decision will be informed, whether it is increasing access for vets or arriving at better outcomes. that is how we will be looking at substance use disorder and mental health more generally. >> we certainly agree on the outcome.

you recently said the demand for tele-mental health is going up. you mentioned that reduced stigma is playing a role in the increase of demand for these services. what should we do in congress to continue lowering the stigma associated with seeking mental health care? sec. mcdonough: thank you for that comment about what i said. when i said is as part of this massive expansion of telehealth, the increase i talked about is uptake on the mental health platforms. some of that may have to do, as i said, hopefully with reduced stigma. it may also have to do with the fact that somebody on a telehealth platform can access those kinds of activities and that kind of support without having, for example, to go into a med center or go to a particular wing. the privacy that the telehealth

platform affords us may also be a really important innovation. this is why it is so critical that we establish now, this pandemic period and the dramatic extension of telehealth, has a new floor, and then we take that even time -- to even higher heights. you can continue to help us as you have with the american rescue plan with additional resources for telehealth platforms, and you can continue to talk publicly about this question of seeking mental health care is as normal and as expected as seeking care for your -- the rest of your whole health. the more we talk about that, the more we modeled that, the better, in my view. rep. trone: we are definitely in vehement agreement on that. many of our vets that have not been to the v.a. in over two years then pass away of suicide. we all know that is an unacceptable way to fail our

vets and an irreparable way. is it difficult to reach these vets primarily at v.a. capacity -- is it difficult to reach these vets? is it a capacity issue? can you shine a light on your efforts to help these vets? sec. mcdonough: when you take about the 19.5 million vets, give or take, that we have in the country, let's say 6.4 million of them rely on us internally for the health care. we are in really good communication with them. they are getting out of our medical centers. up to 9.5 million are enrolled with us but are not constantly seeking care. but they are roughly aware of the services available to them. it may be that they have options

in other places. the real trick is finding that delta between the nine and 19, so the 2 million vets who, for whatever reason, either they are not aware of the capacities, we have not been in touch with them, or we did not do a good job during their transition out of active duty. we have to do better on all fronts, because what we know is the likelier it is a vent is in v.a. care, the likelier the better outcome that vet will experience. the challenge is just getting them into the system, as congresswoman slotkin was saying, which is that we have to get better at getting our vets into our care.

rep. trone: thank you. i yelled back. mr. chairman. rep. takano: thank you. dr. miller meeks, you are recognized for five minutes. rep. miller: makes than you for being with us today -- rep. miller-meeks: thank you for being with us today. i am hoping to expand veterans in employment in the i.t. sector. while the funding of this program was recently increased, and it is a pilot program, i have been told by your staff that the funding will run out because it is so popular. will you increase funding to 125 million dollars a year, what your staff has told us is necessary to keep up with the demand, and if so, why or why not? sec. mcdonough: the short answer

is i do support increased funding on the matter. i would like to get back to you, but the demand is good evidence that the program is working, but i want to make sure we are getting out of always measuring the inputs, i.e. what we invest in, and making sure we are also measuring outcomes. i would like to take the question and make sure i can come back to you consistent with that philosophy, to make sure we are not asking for money that is not proven to be working. notwithstanding demand, which is the most important signal, but i want to make sure that i am staying true to my philosophy. rep. miller-meeks: i appreciate your dedication to being a good fiduciary of the taxpayers' money. we have similar thoughts.

my understanding is that there are already 1500 veterans through my program who have secured jobs, an average of 62,000 a year, which, given the short-term training and the benefits that it has for mental health as we have talked about, are exceptional. is that also your understanding, that the number of -- sec. mcdonough: it is my understanding, and among the various pilots we are testing right now, it is among the highest performers. there is no question about that. rep. miller-meeks: thank you so much. and for rescheduling disability exams, if the veteran is a no-show, being a physician, i know how no-shows are costly to your clinic, to your schedule, and to the backlog, and we know that the backlog increased through the pandemic, which is understandable.

on tuesday's subcommittee hearing, it was reported that in some cases contract vendors do not have adequate information for the veterans to contact them , which causes them to miss exams. as a result, the exam inventory increases even greater than one would anticipate during the pandemic, and the examination has to be rescheduled or reordered and they have difficulties contacting the veterans. is the appointment reminder system available for disability exams, and is the v.a. working with the vendors to expand his capability to contract disability exams and breach veterans? -- will reach veterans? sec. mcdonough: that is an excellent question. my understanding is it is not currently available, but given its success for reviews and scheduling of vaccinations, we are looking at expanding it.

let me take that one for action and come back to you. rep. miller-meeks: i appreciate it. this is important to get through the backlog, but more importantly to get the stamps scheduled, and it is important for the hospitals and contract vendors you have throughout that process. if i have a little bit more time, chair, i have one brief question. ok. your testimony with the cdc estimates that more than 40% of american adults have delayed or deferred care during the pandemic. the v.a. has been a longtime leader in telehealth, and i think the v.a. was better equipped than many in the industry to grant physician care through virtual mediums over the past year.

given what percentage of veterans have delayed over the past year, what are you doing to safely reengage them in care now? sec. mcdonough: that is a question. i do not have potatoes sliced that way, so i can get it for you that way -- i do not have the data sliced that way, so i can get it for you that way. there were 20 million individual appointments that were changed or delayed, and about 96% of those cases, we have been in touch with the individual to make sure that the individual vet to make sure we found a way to address that concern. in fact, performance on urgent care during the course of the pandemic has even helped outperform performance pre-pandemic. we were able to get emergent

cases addressed in something less than a day and a half, which i think is pretty high-performance. the thing we are worried about and which we do not have a good handle on a specific number is a version of the cdc number, but the number of fats who just for went a checkup or something that was not scheduled in the first instance -- the number of vets who just forwaent a checkup or something that was not scheduled in the first instance. the aarp money is important. but let me make sure we come back to you in a way that helps you get your head around the way we have tried to get our head around how big this lump of care coming through the system could look. >> thank for that answer.

i appreciate getting back with you. iq, chair -- thank you, chair takano, for your patience. i yield back my time. rep. takano: thank you. rep. gallego: the coronavirus has put many americans in danger, including veterans. we passed the american rescue plan tate and the efforts. mr. secretary, can you expand on how the rescue plan will help the department fight veteran homelessness? sec. mcdonough: yeah, thanks very much. the investments have been both in the base of cares and the american rescue plan. congress has been helpful in making sure we have the resources. among the things it has allowed us to do our making sure that at risk vets get support to stay

where they are through rental assistance, making sure that we put up a moratorium on evictions or foreclosures, and we get emergency mortgage support for emergency support further utility bills. -- for their utility bills. that can continue. the second thing we do, i think it was mr. murphy, if i'm not mistaken, but mentioned that a big challenge we face relates to availability of affordable housing. the hud program is a big part of our ability to address that. so funding for both us and hud allows us to make sure the

vouchers are substantial enough to allow us to address the high-priced markets. lastly, it has allowed us to get care, including mental health care, substance abuse treatment, to both at risk and homeless ve ts, including ensuring homeless vets are in touch with care providers during the pandemic. those are a couple examples. the situation must have gotten worse during the course of the pandemic, but because of the way -- this is another data thing -- like, i love the annual headcount and i am glad to participate in it, as i have many times over the years, but we have to get better and more

actionable information about the nature of the homelessness challenge for our vets. we are trying to scope that more aggressively. rep. gallego: is there an amount -- we allocated some flicks ability -- flexibility, 14.5 million dollars more for the department. will you consider that when dealing with homelessness? sec. mcdonough: the number sticking in my mind is between 600 million dollars and $700 million, mr. gallego, but let me get back to you with precision, because i want to make sure i am not keeping you. that is added into the base budget, the cares money, and the aarp money. rep. gallego: and then what other elements of the american

risk plan more broadly will help the department fight veteran homelessness? sec. mcdonough: obviously, the support to increase care. when we think about somebody in a situation where, as i said earlier, we know that in earlier periods of softness in the economy, vets lose their jobs and therefore their employer covered health care insurance, bc the demand for v.a. services increase in those areas as well. that is going to be a part of this increase and overall care requirements that come from people during the pandemic who, for whatever reason, including homelessness, who have forgone care in the system, therefore

meaning that they may come back with more complicated issues for us to address. >> thank you. thank you mr.. i now call on miss cap -- missed after for five minutes. >> thank you mr. chairman. mr. secretary, we do not want to wear you out. seems like you're holding pretty up while there. congratulations, we are proud of you and your service to our country. the first questions are simple questions relating to data and staffers at the v.a. we can work with. number one, on any given day at the v.a., what percentage of beds across the entire system of hospitals and health care facilities are occupied by vets who present with behavioral health conditions including neuropsychiatric, and what percentage of that have some type of addiction?

that is number one. i am looking for data. number two, in my home community, we have a food bank that gives a great deal of support to veterans who have a given day they come to the food bank and with the food bank is interested in now working with veterans to begin to grow vegetables and produce food for these individuals. who at the v.a. could we talk to, social workers, project rectal's, some regional person who could help us put to -- project directors, some regional person who could help us put that together? number three, across the country we know the field of neuropsychiatry and behavioral science, we are 100,000 doctors short. i was confronted by constituents today who is not a veteran but cannot take care because there are no doctors that specialize in these conditions. with 100,000 doctors, physicians

who are behavioral specialists and psychiatrists lacking across our country and four times that many advanced practice nurses who specialized in these fields. how can we use the power of the v.a. and the power of dod and the power of hhs to begin to draw, perhaps, from the deity medical core as people are discharged or thinking about what they will do with their lives, developing more platform, to help educate and advance individuals who would be very good at being physicians and advanced practice nurses in these fields. but somehow, they slipped through the tracks -- through the crack's. i would appreciate your ideas on that. you do not need to answer that now because it is a big question. but we know we have to solve this problem. i even thought of helping to pay for people's education.

and then allowing them to work both on the veteran's side, as we lack these doctors on the civilian side as well. and then i forgot one thing. we are working with our governor here in ohio to remodel the second floor of a psychiatric hospital that is a forensic hospital. a miserable place. we lack doctors, the private -- the proper care for these individuals. at least upwards of a third or more of in the jails of ohio are mentally a. that's a failing grade. in ohio, we will put money into this in the state. to rebuild a wing -- could we build a wing that could accommodate our vet scott -- our vets? who could we talk to at the v.a. knowing the small doctor -- the small amount of doctors we have

-- i really need your help. you have the kind of background that could help us figure this out. not just at the v.a., but there are other things we can do at hhs and other departments, including dod to make a real difference. just sort of respond in general on that one. if you could get someone back to us on the shelter plus care for vets, whose simple he cannot make it on the street. >> on your first question, i do not have the data. i will get that for you. one piece of this data that might help, over the last year, fy 20, we saw 1.5 6 million vets that sought mental health care services in vha.

1.5 6 million. that is a fourth of the vets who seek overall care in the system. who rely on the v.a. for all their care. that is one way to cut it. let me cut the data another way. percentage of beds on any given night. >> thank you. >> second, the integrated services that i think i know the right person to talk to and i have emailed with him last night at 1130, but his name is escaping me at the moment. i will follow-up with your office might or tomorrow -- with your office tonight or tomorrow. we have a strategic shortage in

the country of mental health professionals. the universities say this. private hospitals say this. dod says this. we experience this. and the v.a.. we are getting very good at creative and ended -- and innovative ways to help by being super nimble and agile. we have mental health professionals that work in the v.a. and in the university settings. we have to train more. the v.a. has a great history. dr. murphy himself said some of his training was at a v.a. facility. as a surgeon. we are looking at ways to expand and grow on the historic -- i

mean historic by meaning historical, as well as historic v.a. commitment to medical center educational alliances that go back to general bradley and the earliest days of the v.a. the question for us is, how can we spend that more? we are looking at the question, too. i do not have a specific set of answers to that question yet. one of the meetings that is actually happening right now -- if i do finish, i will join them -- is with our mental health professionals across the v.a. system on what they are doing to highlight this need and to grow capacity to fill the need. i will be able to follow-up with you on that, too. the long answer is, i think you are right. in previous years, previous crises, when we faced shortages,

linguists, technologists, dod, v.a. and our funding, and hhs, end up being important in filling that. i think it is an opportunity. >> thank you. >> thank you. thank you for your questions about expanding medical residencies. with that, we have our very own dr. for five minutes. >> thank you, chair. thank, mr. secretary. so great to see you again. so great to see you in this capacity. we have such high hopes and all the good work you're going to do. i'm wearing my white coats to give everyone confidence because i'm having hope that with president biden's federal retail pharmacy program, not going over

1000 of our hardest hit hardest to reach to reach communion members, farmworkers in desert mirage high school in the eastern coachella valley, it is working. please send my immense gratitude for the focus on equity. as a representative of a large population, i am committed to ensuring our service members receive the highest quality health care possible. over the years i've been especially focused on getting veterans that have been exposed to toxic get the benefits and care they need. i founded the bipartisan burgett caucus. it is this generations agent orange. it continues to burden the health of service members, many of whom become severely sick or die from respiratory failure, cancers, and autoimmune diseases. i was introduced to the effect when a constituent, a 39-year-old air force veteran

with a healthy lifestyle, came to my office for help. she was battling pancreatic cancer, which are -- which was likely due to a wert -- exposure at a large air force base in iraq. she died, leaving behind her husband and two young children. she is the inspiration of my advocacy. i would be remiss if i did not mention that this issue touches families around the country. president biden has indicated numerous times that his sons cancer might also be linked to this. it is time to ask, mr. secretary. i hope you will be a partner in taking urgent action. veterans in this country need advocates, not obstacles. secretary mcdonagh, and your testimony you mentioned you initiated an internal process for establishing service connections for veterans who may have been exposed to airborne hazards during their military

service. can you elaborate on what that review entails and your plans to work proactively with congress to address toxic exposure? sec. mcdonough: thank you for doing the vaccine work you're doing. what i said is, in the first meeting of the veterans administration executive board on tuesday afternoon, this was the topic. we agreed a number of things in that meeting. one is that we would be active, rather than waiting, for new research. that means we will seek additional partners, including the national institutes of health and the national institute of cancer. organizations like the firefighters who have been exposed, to similar kinds of chemicals. they have access to research and

science that will help us. in our deliberation. this is on top of our own research out of v.a. and coronation with dod. to figure out precisely what's our vets and our active-duty have been through. >> thank you, mr. secretary. i would love to be a very involved partner in your decisions. just to be clear, our veterans are dying right now. they cannot afford to wait decades for that perfect 20 year longitudinal double cohort study by vietnam veterans -- like vietnam veterans were forced to with agent orange. in a sphere weeks i will introduce the percentage benefits act with senator gillibrand. this bill will give veterans who develop respiratory diseases the

health coverage they need and deserve. i look for to continuing to work with you. we had a mellow -- a medical fellow in my office that did a literature review, identified respiratory illnesses that have some association. we also know there are carcinogens and the smoke. we have people dying of brain cancer, pancreatic cancer, gastric cancer, all kind of cancer. this different than agent orange. there are hundreds of toxic chemicals. getting a grasp of this and getting the veterans care and the needs they deserve is going to be life-saving. i look forward to being a partner with you, personally, in establishing this with the leadership of chair katana who i understand is committed to this issue. thank you and i yield back. >> thank you to dr. ruiz. snazzy coat you have on there.

>> come on down. you're more than welcome. it is your county. >> already. great neighbor i have -- great neighbors i have. always great to have a cardinal attend your meetings. love it -- lovely to have ms. kaptur been our committee. before i getting to my summary -- my closing statement, i want to know if there any other members on the call who have not gone yet who would like to ask questions. otherwise, i will quickly make my closing statement, which is very brief. i've already made it. with regard to my hope to work on medical residencies. we will need to address the

increased needs of veterans who will be seeking care at the v.a.. if we go, we might be going with regards to toxic exposure. certainly appreciate all of the questions from both sides of the aisle. it was an impressive hearing of goodwill. towards the new secretary. i know we are all looking forward to working with him. miss kaptur, i do not think we wore him out. i think he is pretty strong. with that, before we close us out -- >> i wanted thank the secretary. i know it has been a long meeting. you answered a tremendous amount of questions. we look forward to working with you. thank you for being here. i'm looking forward to having you back many times. >> thank you. >> i want to thanks the

secretary again for joining us today on the future of -- on the hearing of the future the v.a.. we will shape the v.a. into organization so that it is efficient, effective, and veteran centric. we have to work together. i truly appreciate your commitment to your job and our veterans. all members left five legislative days to provide and extend their remarks and include extraneous material. thank you again for appearing